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General NPI Number Information
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NPI Number | 1750570537
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Entity Type | Organization
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Legal Business Name | RAMIN ETEBAR MD LTD
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 2555 MONTESSOURI ST SUITE B
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City | LAS VEGAS
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State | NV
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Zip | 89117-3058
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Country | US
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Telephone | 702-870-1800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35288
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City | LAS VEGAS
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State | NV
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Zip | 89133-5288
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Country | US
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Telephone | 702-870-1800
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | RAMIN ETEBAR
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Credential | MD
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Telephone | 702-870-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 6788
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License Number State | NV
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